A hospice has announced it must close eight beds and make 21 staff redundant, including 15 clinical roles, to cope with financial pressures.
St Giles Hospice in Lichfield, Staffordshire, warned in the summer it was dealing with a £1.5m a year deficit, as hospices warned nationally of a funding crisis.
“I’ve got a group of donors who are phenomenally generous but who are also feeling the squeeze, and an NHS income that isn’t keeping up with inflation,” said Elinor Eustace, its interim chief executive.
The government said the employer National Insurance rise takes effect in April and it would set out funding allocations for 2025 in due course.
Thousands of people are treated by the hospice’s at-home scheme, which could become harder to access as a result of the cuts.
“By having to reduce our services we are ultimately going to have to reduce the [number of] people that we look after,” said Kristy Clayton, director of clinical services.
She previously told the BBC she could easily fill the unit’s 23 beds twice over and having to decide who to prioritise was “incredibly heartbreaking”.
Nurses are among roles being cut at the hospice, which has shocked staff.
“As a nurse you think that’s always going to be a job that’s going to be a certainty,” said Kristie Dann, clinical nurse specialist.
“So that was really, really hard.”
St Giles has an annual budget of £10m, with more than three-quarters of its staff in clinical positions.
Five years ago, NHS funding covered about 25% of costs – but this has fallen to 17.7%.
Ms Eustace told the BBC the hospice employed 292 staff prior to a transformation programme to address the deficit. The 21 jobs to go include 15 clinical and six non-clinical staff.
She said the hospice sector was experiencing a “collective £77m deficit across the UK” and funding needed to change.
“If something doesn’t change in terms of the way in which hospices and end-of-life care is funded, then there is the potential that many hospices will close over the next 10 years,” she said.
Hospice UK has called for urgent cash investment from the government.
A government spokesperson said it had taken “tough decisions” so a £22bn boost for the NHS and social care could be announced in the Budget.
“We want everyone to have access to high-quality end-of-life care and are aware of the financial pressures facing the hospice sector, and of the huge generosity of the British public, whose donations provide a significant proportion of hospice funding,” they said.
“We are determined to shift more healthcare into the community and ensure patients and their families receive high-quality, personalised care in the most appropriate setting, and hospices will have a big role to play in that shift.”
Meanwhile, families helped by the in-patient care in Lichfield said it was vital.
Wendy from Burntwood, who is terminally ill, told the BBC spending her final days in the hospice had brought her peace, while the service and staff were “brilliant”.
“They have given me a calming feeling,” she said.
“Everybody has done more or less what was needed and for that I can’t thank these people enough.”
She marked her 77th birthday in the hospice, reading loving cards and good wishes from family and friends.
John, her husband of 56 years, added: “Politicians – they should be funding this place to the hilt.
“There can’t be a better place in the world than this. It really is that good.”